The fear for Endometriosis
The biggest fear the patients experience after being diagnosed with endometriosis is that they will be infertile. The most common mistake made by endometriosis patients is to believe that any gynecologist has sufficient training to manage this condition. Unfortunately, many physicians believe that burning or using the laser to vaporize endometriosis is sufficient. It is not. Endometriosis must be excised completely to get the best results. Too often, physicians find they cannot adequately manage the disease and quit before the disease is adequately treated. The next most common mistake is not being aware that the use of a GnRH-agonist such as Lupron can be carried out without the side effects of low estrogen, like hot flashes, sleep disturbances and bone loss, if they are placed on add back therapy at the time Lupron is started. Again, many physicians lack the experience or knowledge to prescribe the medication in this fashion. The third most common mistake is to think that taking Lupron outside of an ovulation induction or IVF cycle will improve the odds of pregnancy. Again, many physicians mistakenly believe this is the case.
Doctors prescribe Lupron for patients with pelvic pain who wish to avoid surgery or after surgery to prevent recurrence. Doctors use Lupron with add back estrogen and progesterone therapy to minimize side effects.
A combination of hormonal therapy and surgery may offer the best results for treating the pain associated with endometriosis. If a woman is primarily concerned with fertility, and there is significant tubal damage, IVF is usually the best option.
The recommendation for some alternative therapies are dietary management, massage therapy, stress reduction and counseling where appropriate.
When coming to deal with patients who experience self-esteem issues or depression because of the disease, the first step is to listen and accept the patients concerns as valid and to admit the limitations in solving many endometriosis associated problems. Medications and counseling are also important.